Unsolved Enigma of Atrial Myxoma with Biventricular Dysfunction

Coexisting coronary atherosclerosis and coronary embolization of tumor fragments causing myocardial ischemia are well‐known reasons for ventricular dysfunction in patients with left atrial myxoma. The incidence of coronary artery disease in patients with myxoma is between 20.3% and 36.6%.[2,3] Other proposed explanations for the left ventricular dysfunction in such patients were hypercoagulability state in patients with myxoma and raised interleukin‐6.[3] Cases reported by Tewari et al. did not undergo preoperative coronary angiography. The reason, we believe, may be younger age groups and hence coronary artery disease was not suspected. Interestingly ventricular function improved immediately after the removal of myxoma. Previously we reported a case of left atrial myxoma with biventricular dysfunction despite having normal coronaries angiographically.[4] However, ventricular function didn’t improve even after removal of tumor. We believe that undiagnosed concomitant dilated cardiomyopathy could have been the reason.